Organization
FREDERICK PSYCHIATRIC MEDICINE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
CORVIN ROBINSON M.D. (OWNER)
(301) 606-7785
Entity
Organization
Contact information
Practice address
10001 PEBBLE BEACH TER, IJAMSVILLE, MD 21754-9147
(301) 606-7785
(240) 310-1927
Mailing address
10001 PEBBLE BEACH TER, IJAMSVILLE, MD 21754-9147
(301) 606-7785
(240) 310-1927
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
DOO44857
MD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
00823
VALUE OPTIONS
—
01
—
60054
AETNA
MD
01
—
D0044857
MEDICAL LICENSE
MD
05
—
MDMCD
—
MD
01
—
SB580
BLUE CROSS/BLUE SHIELD
MD
05
—
SKMDO
—
MD
01
—
SX173
BEACON HEALTH
MD
Enumeration date
12/19/2016
Last updated
12/19/2016
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